Osteoporotic vertebral compression fractures (OVCFs) are common in elderly patients with reduced bone density. Pain and loss of function after fractures have a serious impact on the patient's activities of daily living and quality of life. Management of patients with early OVCFs who choose non-surgical treatment is necessary to prevent complications, relieve pain, and improve functional status. This paper focuses on the development of OVCFs non-surgical management in many aspects, which may provide reference for the rapid recovery of OVCFs patients in the process of non-surgical management.
Objective To analyze the demographic and clinical characteristics of inpatients with osteoporotic vertebral compression fractures (OVCF) and provide a basis for clinical prevention and treatment. Methods A retrospective analysis was performed on the clinical data of 744 inpatients diagnosed with OVCF between January 2017 and December 2021, who met the inclusion criteria. Among them, 146 were male and 598 were female, with ages ranging from 50 to 95 years (mean, 69.37 years). The analysis covered various demographic and clinical characteristics, including causes of injury, history of vertebral fractures, smoking and drinking habits in males, comorbidities (hypertension, diabetes, coronary atherosclerotic heart disease, cerebral infarction), body mass index (BMI), blood lipid levels, menopausal age in females, vertebral bone mineral density T-scores, sites and counts of vertebral compression fractures, and fracture segment distribution. Additionally, correlation and multiple linear regression analyses were performed to identify potential factors influencing osteoporosis. Results The demographic analysis indicated that female patients with OVCF were significantly younger than male patients (P<0.05). A significant difference in the age distribution at the onset of OVCF between genders was observed (P<0.05). The highest proportion of male patients was in the 70–80 age range (37.0%), while the highest proportion of female patients was in the 60-70 age range (37.6%). From 2017 to 2021, the age of onset for OVCF gradually increased, with similar trends observed in both genders. Occupational distribution varied significantly between genders (P<0.05); the most common occupations among males were farming (48.6%), retirement (24.7%), and manual labor (13.7%), whereas females were primarily engaged in farming (51.5%), retirement (19.4%), and service worker (10.0%). Female patients had higher BMI, higher vertebral bone mineral density T-scores, and a higher incidence of previous vertebral fractures compared to male patients (P<0.05). No significant gender differences were found in ethnicity, seasonal distribution, regional distribution, urban-rural distribution, causes of injury, fracture count, or comorbidity rates (P>0.05). A total of 1 309 vertebrae were affected in 744 OVCF patients, with 628 thoracic vertebrae (48.0%) and 681 lumbar vertebrae (52.0%). The most frequently fractured segments were L1 (22.5%), T12 (21.2%), followed by L2 (12.2%) and T11 (10.2%). No significant gender differences were observed in fracture segment distribution (P>0.05). Correlation analysis showed no significant relationship between smoking and drinking history in males, menopausal age in females, and vertebral bone mineral density T-scores (P>0.05). However, a positive correlation was found between the history of vertebral fractures and the number of vertebral fractures (P<0.05), and a negative correlation between vertebral bone mineral density T-scores and the number of vertebral fractures (P<0.05). Multiple linear regression analysis identified advanced age, female gender, and lower BMI as independent risk factors for vertebral osteoporosis (P<0.05). ConclusionThe age at onset of OVCF has increased gradually over the years. The incidence, age distribution, occupational distribution, causes of injury, BMI, history of vertebral fractures, hypertension, and blood lipid levels exhibit gender-related differences, while seasonal distribution, fracture segments, and other comorbidities do not. OVCF predominantly occurs in the thoracolumbar region. Female gender, advanced age, and lower BMI are independent risk factors for osteoporosis, with patients having more severe osteoporosis showing a higher number of vertebral fractures.